Researchers meet to discuss new model for accurate TB detection


The Philippine Council for Health Research and Development held a forum on the TB Filipino Impact Testing (FIT): Impact Assessment of Diagnostic Algorithms and Tools for Multi-Drug Resistant (MDR-TB) and Drug Sensitive Tuberculosis (TB) in the Philippines last April 25, 2018 at the NIH Conference Room, UP Manila.

Proponent of the study Dr. Charles Yu of De La Salle Health Sciences Institute (DLSHSI) and Mr. Ewan Tomeny from the Liverpool School of Tropical Medicine (LSTM) in UK delivered the presentation on the initial results and future implications of the project on the cost effectiveness of TB diagnosis in the country.

TB FIT is one of the projects under the Newton Agham program under the Medical Research Council (MRC) – UK and PCHRD collaboration. The program extends assistance to projects that helps improve health outcomes through research-based solutions and innovations.

According to Dr. Yu, the study is being conducted to support the cost-effective roll-out of new tools and algorithms for the diagnosis of multi-drug resistant tuberculosis and drug-sensitive tuberculosis in the Philippines. He explained that this will lead to the delivery of improvement to TB/MDR-TB case detection in the Philippines, as well as promote the economic development and welfare of the country.

The project developed a computer model to assess the impacts of different diagnostic algorithms for TB including new and currently available tools. It was designed to represent patient pathways at specific sites that will be used to compare the impacts and cost-effectiveness of different diagnostic algorithms.

Initial results from modelling Cavite sites shows that rolling out GeneXpert as a replacement to microscopy is cost-effective where drug sensitive and MDR-TB cases are correctly treated. Moreover, it has been shown that most of the alternative diagnostic algorithms modelled would significantly reduce patient costs .

Mr. Ewan Tomeny discussed that  the virtual implementation modelling can provide a better understanding of current and potential future patient pathways through visualization, comparison of options by projecting the patient and health systems evidence over extended timeframes, estimation of patient and health system costs, and assessment of incremental cost effectiveness of scale up.

The next stage of the research will look at data from additional provinces in the Philippines. Data will shortly be available for Davao and Bulacan. LSTM will support the DLSHSI and National TB Control Program (NTP) in using the models to evaluate alternative diagnostic algorithms in these provinces and then across the Philippines.

The forum was an opportune moment for researchers and medical practitioners to discuss and assess the current TB situation in the Philippines, most of them were interested in using the model and apply it to the detection of other diseases such as dengue or HIV.

TB FIT is one of the six projects of the 1st cycle of the Newton Agham program that is able to produce quality results that impacts public health. Encouraged by the success of the first six projects in Cycle 1, the Medical Research Council – UK (MRC) and PCHRD launched the second cycle of the Newton Fund last March 2, 2017 where 12 concept proposals were shortlisted for full proposal development.